Don’t Lose Out on Potential Reimbursement! (NH)

If your district uses Lumea, please be sure all of your OOD student data is correct in your Lumea account, including OOD placement information, district of liability, okay to bill Medicaid, and 402 status. OOD services will not be billed in your Lumea account, but we do use your account to verify placement and other pertinent information. If your district does not yet use Lumea and you sent us a paper OOD Roster, please let us know about any OOD placement changes and what dates they took effect.

Out of District Facilities with Lumea Accounts:

If you have a student placed at Easter Seals, RSEC Academy, Seacoast Learning Collaborative, Spaulding Youth Center, or Strafford Learning Center, you have the ability to review your students’ records online by requesting access as an OOD Reviewer in those accounts. Once approved, the Out of District Lumea Administrator will need to assign your caseload of students. You do not need to print records from those accounts, as the auditor will review them online, including electronic signatures. If you would like assistance with requesting access to another Lumea account, please contact our Customer Care Team at 1-866-226-6159 or via Live Chat and they will be more than happy to help you request access for a specific account.

For All Other Out of District Placements:

Please be sure you are receiving compliant service records or transaction logs, signed by the practitioner in original ink, and are forwarding those records to MSB.

AS A REMINDER:

402:

If you have 402 (court-ordered) students placed out of district, please check to see whether any of your students have met the 402 cap, and notify MSB of the date the cap was met if you have not already done so. A delay in notifying MSB that a 402 cap has been met could result in future recoupments and audit findings.

Waivers:

If you have submitted a waiver request and have not yet received a response, we would encourage you to follow up with the state to avoid having claims expire. Waivers are required for all out of state mental health providers as well as any New Hampshire mental health counselor who is not certified by the NH DOE as a school guidance director, school guidance counselor or school social worker.

As always, feel free to contact your Claims Analyst. Our goal is to do whatever we can to help you maximize your Medicaid reimbursement while striving for the highest level of compliance. We appreciate the opportunity to partner with you as you provide essential services to children throughout New Hampshire.